Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02844 | Date 20/08/2019 |
| Token No | SM/18-19/5736 20/08/2019 | Serial | 004 |
| Patient Name | Mr. BINOD RAM | Contact No | 8013548536 |
| Address | 4 DEY GHAT LANE | Age | 30 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||